The first human case of Trichinella spiralis infection in Korea

Abstract

Three cases of human infection by Trichinella spiralis were first confirmed by detecting encysted larvae in the biopsied muscle in December 1997, in Korea. The patients were one 35- and two 39-year-old males residing in Kochang-gun, Kyongsangnam-do. They had a common past history of eating raw liver, spleen, blood and muscle of a badger, Meles meles melanogenys, and complained of high fever, facial and periorbital edema, and myalgia. Hematologic and biochemical examinations revealed leukocytosis and eosinophilia, and highly elevated levels of GOT, GPT, LDH and CPK. In the gastrocnemius muscle of a patient, roundly coiled nematode larvae were detected. The larvae measured 0.775-1.050 (av. 0.908) mm in length, and 0.026-0.042 (av. 0.035) mm in maximum width. The specific IgG antibody levels in three patients' sera were significantly higher when compared with those of normal controls. The patients were treated with flubendazole and albendazole for 15-30 days, and discharged at 13-34 days post-admission. From the above findings, it was confirmed that T. spiralis is present in Korea, and the badger plays a role of as the natural host.

Fig. 1

A coiled Trichinella spiralis larva in the biopsied gastrocnemius muscle of a patient at 34 days after eating raw badger.

Figs. 2-5

Larvae of Trichinella spiralis detected from muscle biopsy of the patient. Fig. 2. A sectioned larva in the worm cyst of muscle biopsied at 34 days after infection (H-E stained). Fig. 3. Enlarged view of Fig. 2, showing the intense inflammatory response around the nurse cells (arrow heads)-larva (L) complex (H-E stained). Figs. 4 & 5. Two larvae in press preparation of muscle biopsyed at 41 days after eating raw badger (at 10 days after treatment with flubendazole and albendazole). The larvae detected at the same day were uncoiled and did not show the infectivity in mice and a hamster. The bar represents µm in length.